• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

ecw Leaderboard Ad
  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Life Sciences
  • Investments
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage

Health IT for Emerging “Payviders”

by Priscilla Sandberg, Healthcare Alliance Manager, Pure Storage 10/10/2022 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print
Health IT for Emerging “Payviders”
Priscilla Sandberg, Healthcare Alliance Manager, Pure Storage

Though doubts about the benefits of the “payvider” model certainly exist, the success of recent payer-provider partnerships showcases the potential of these programs to improve the patient and provider experience. A study of Aetna’s integrated program, for example, found that plan members could realize significant savings for high-cost chronic conditions and experience fewer hospital admissions. A similar report from Cigna echoed these conclusions, finding that integrated benefit plans resulted in increased patient engagement. Synthesizing data from payers and providers increases visibility into the patient, giving healthcare professionals the context they need to improve health outcomes and streamline care.

The slow expansion of payvider networks is not out of a lack of interest in emulating programs like CVS Health/Aetna or Cigna. In fact, according to a survey by the Healthcare Financial Management Association, 60% of providers aim to follow suit and become payviders this year. However, the same report shows that data and technology costs pose significant barriers to implementation. 

The main benefit of this model is the ability to share population and individual information to create a more holistic view of a patient, but if data is splintered across various networks, neither partner will be able to capitalize on these opportunities. For payers and providers to access and analyze information from care coordination platforms, pharmacy benefit reports, and electronic health records, they need interoperable and flexible data storage solutions.

Future-ready IT for growing organizations

The healthcare industry generates approximately 30% of the world’s data volume, and data growth in this sector will continue to increase exponentially. Payviders need solutions that securely store all this data and also keep patient charts, notes, images, patient-generated data, and other clinical information accessible and shareable. To provide this comprehensive care to their members, payviders must first expand their network reach. Acquiring clinics and in some cases, other plans, allows them to grow their business and increase member satisfaction.  

With acquisitions comes the challenge of managing disparate application sets and often separate infrastructures. To control costs, payviders should consolidate infrastructure to support their different business units. When bringing on a new physician practice or plan, data storage grows, often in unpredictable ways. Traditional management methods often require organizations to rip and replace infrastructure that is not capable of supporting new workloads, resulting in costly and time-consuming conversions. With patient data at risk, conversions may cause interruptions in care and jeopardize the validity of clinical data.

A storage infrastructure model that allows these organizations to expand their footprint without conversions or downtime not only saves time and money but also puts the patient data first.  Members demand real-time access to their EHR and Insurance information, and downtime compromises their ability to manage their care. To effectively scale out their infrastructure support, organizations must consolidate their data storage in a centralized, always-on solution rather than in separate infrastructure locations. On-demand storage-as-a-service solutions are the key to managing massive amounts of data, ensuring that the organization’s IT can grow alongside the company itself.

Artificial intelligence and machine learning capabilities for next-gen analytics

Compiling and streamlining data is nearly useless without a method of analyzing the information to uncover actionable insights. Although traditional analytical models are useful for hypothesis-driven research, organizations of the future need to leverage artificial intelligence and machine learning to find patterns in massive data sets. With visibility into the payer and provider side of healthcare delivery, data teams can predict crisis events, promote personalized care, and determine patients at risk. AI systems can pinpoint population-level data to identify predictors of certain chronic conditions or analyze a patient’s records to better inform accurate diagnosing. Ultimately, these technologies provide organizations with the information they need to provide better preventative care and reduce hospital and emergency department admissions. 

Despite all of these benefits, few organizations are using these artificial intelligence capabilities in a meaningful way. According to a Deloitte report, 90% of healthcare professionals surveyed believe AI is important to their organization, but many cannot capitalize on the technology because of siloed, unintegrated data sets.

For healthcare organizations to maximize the potential of these next-gen analytical tools, they need AI-ready storage solutions.  Whether it’s on-premises or in the cloud, much of the existing legacy infrastructure technology requires teams of data scientists to run analytics and transfer data to ML-supported platforms, leading to significant delays. Implementing new, AI-ready infrastructure can accelerate the speed to insight, facilitating innovation and producing actionable, modern analytics. 

Expanding the functionality of healthcare IT

As the healthcare industry continues to undergo digital transformation, investing in flexible, multi-purpose IT across the entire organization will be paramount. Healthcare technologies no longer serve singular purposes. An EHR is not just a collection of visit summaries, but a compilation of patient-generated data, physician notes, and clinical images that are integrated into a comprehensive view of a patient’s health. Telehealth platforms have expanded beyond video chats to include asynchronous care delivery, voice analytics, and automatic clinical note generation. Similar innovation exists in the data storage space, helping organizations store, protect, and analyze the billions of gigabytes of information that are generated on patients.

For payviders particularly, future-ready IT is a must. The benefits of closer payer-provider relationships are becoming clear as these newer organizations continue to expand and report patient outcomes and business performance data. The future of healthcare is always unpredictable, so why should organizations invest in solutions that can’t adapt and grow with them? Every day, data becomes more crucial to understanding patient populations and improving their treatment and coverage. With flexible, AI, and cloud-ready storage, these organizations can ensure that their IT is prepared to support their evolution.


About Priscilla Sandberg

Priscilla Sandberg is a Senior Healthcare Strategic Alliances Manager at Pure Storage, helping to expand the company’s Healthcare Vertical, with the goal of providing state-of-the-art storage infrastructure to organizations, ensuring that clients have the tools to meet the ever-changing data capture and reporting requirements of today’s healthcare environment.

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tagged With: Aetna, AI, Artificial Intelligence, Care Coordination, Cigna, cloud, CVS Health, digital transformation, Health IT, healthcare delivery, healthcare it, Machine Learning, model, patient engagement, Patient-Generated Data, Payers, Pharmacy, Physician Notes, physician practice, risk, video

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

How eClinicalWorks is Harnessing AI and Telehealth to Support Rural Healthcare Organizations

Most-Read

GE HealthCare Acquires Intelerad for $2.3B to Create Cloud-First, AI-Enabled Imaging Ecosystem

GE HealthCare Acquires Intelerad for $2.3B to Create Cloud-First, AI-Enabled Imaging Ecosystem

Humana Partners with Sunrise to Expand Digital Sleep Apnea Diagnostics

Humana and Epic Launch Coverage Finder to Deliver Digital-First Medicare Advantage Check-In

Cleveland Clinic and Khosla Ventures Form Strategic Alliance to Accelerate Healthcare Innovation

Cleveland Clinic and Khosla Ventures Form Strategic Alliance to Accelerate Healthcare Innovation

Northwell Health Selects to Deploy Abridge’s Ambient AI Across 28 Hospitals

Northwell Health to Deploy Abridge’s Ambient AI Across 28 Hospitals

Omada Health Launches "Nutritional Intelligence" with AI Agent OmadaSpark

Omada Health Launches AI-Powered Meal Map to Transform Nutrition for Cardiometabolic Patients

From Overwhelmed to Optimized: How AI Agents Address Staffing Challenges and Burnout in Healthcare

From Overwhelmed to Optimized: How AI Agents Address Staffing Challenges and Burnout in Healthcare

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Qualtrics Acquires Press Ganey Forsta for $6.75B to Create the Most Comprehensive AI Experience Platform

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

Pfizer and Trump Administration Announce Landmark Agreement to Lower Drug Costs

KLAS Report: Epic's Native Ambient Speech Tool Reshapes Customer AI Strategies

KLAS Report: Epic’s Native Ambient Speech Tool Reshapes Customer AI Strategies

Epic Unveils MyChart Central and New APIs to Advance Interoperability at Open@Epic

Epic Outlines Roadmap for Next-Generation Data Sharing at Open@Epic

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Op-Ed Submission Guidelines
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |